Alan Wrench

Chewing and swallowing after surgical treatment for oral cancer: functional evaluation in 196 selected cases.

One hundred ninety-six patients treated for oral cancer between 1992 and 1999 self-scored their speech, chewing, and swallowing using a new self-questionnaire (Functional Intraoral Glasgow Scale) developed at Canniesburn Hospital, Glasgow, to assess the functional efficiency of patients treated for intraoral cancer. The patients were distributed into 12 homogeneous groups, according to the site and size of surgical resection, carefully mapped out on standard diagrams of the oral cavity. The functional outcome for chewing and swallowing was correlated to the site and size of resected tissue, to the reconstruction modality, and to radiotherapy and compared with the speech quality. The general trend is very similar for both chewing and swallowing; the smaller the resections, the better the functional outcome. Chewing was mostly affected by resections of the floor of the mouth, whereas swallowing was mostly affected by demolition of the base of the tongue and of the retromolar trigone. Speech showed a better postoperative recovery than chewing and swallowing. The reconstruction modality did not influence the eventual outcome for either function. Radiotherapy in combination with surgery is a negative functional prognostic factor. A correlation between site and size of excision and functional outcome is presented using color multiple-view diagrams for immediate appreciation to identify positive and negative prognostic factors.

Advances in EPG palate design.

Electropalatography (EPG) is a highly effective tool for speech research and for the diagnosis and treatment of a range of speech disorders. The technique requires an EPG palate to be custom made for each user. The manufacture of the palate is both costly and time consuming and inhibits wider uptake of the technique. This paper undertakes a thorough re-examination of all aspects of EPG palate design including criteria for selecting the number and location of contacts, materials properties, costs and safety issues. Palate design over the last 30 years is reviewed and a new design (the Articulate palate) is proposed based on the findings, which minimizes cost while maximizing comfort, safety, convenience, reliability and accuracy.

Using ultrasound visual biofeedback to treat persistent primary speech sound disorders

Abstract Growing evidence suggests that speech intervention using visual biofeedback may benefit people for whom visual skills are stronger than auditory skills (for example, the hearing-impaired population), especially when the target articulation is hard to describe or see. Diagnostic ultrasound can be used to image the tongue and has recently become more compact and affordable leading to renewed interest in it as a practical, non-invasive visual biofeedback tool. In this study, we evaluate its effectiveness in treating children with persistent speech sound disorders that have been unresponsive to traditional therapy approaches. A case series of seven different children (aged 6–11) with persistent speech sound disorders were evaluated. For each child, high-speed ultrasound (121 fps), audio and lip video recordings were made while probing each child’s specific errors at five different time points (before, during and after intervention). After intervention, all the children made significant progress on targeted segments, evidenced by both perceptual measures and changes in tongue-shape.

Advances in EPG for treatment and research: an illustrative case study.

Electropalatography (EPG), a technique which reveals tongue‐palate contact patterns over time, is a highly effective tool for speech research. We report here on recent developments by Articulate Instruments Ltd. These include hardware for Windows‐based computers, backwardly compatible (with Reading EPG3) software systems for clinical intervention and laboratory‐based analysis for EPG and acoustic data, and an enhanced clinical interface with client and file management tools. We focus here on a single case study of a child aged 10± years who had been diagnosed with an intractable speech disorder possibly resulting ultimately from a complete cleft of hard and soft palate. We illustrate how assessment, diagnosis and treatment of the intractable speech disorder are undertaken using this new generation of instrumental phonetic support. We also look forward to future developments in articulatory phonetics that will link EPG with ultrasound for research and clinical communities.

Recording speech articulation in dialogue: Evaluating a synchronized double Electromagnetic Articulography setup

We demonstrate the workability of an experimental facility that is geared towards the acquisition of articulatory data from a variety of speech styles common in language use, by means of two synchronized electromagnetic articulography (EMA) devices. This approach synthesizes the advantages of real dialogue settings for speech research with a detailed description of the physiological reality of speech production. We describe the facilitys method for acquiring synchronized audio streams of two speakers and the system that enables communication among control room technicians, experimenters and participants. Further, we demonstrate the feasibility of the approach by evaluating problems inherent to this specific setup: The first problem is the accuracy of temporal synchronization of the two EMA machines, the second is the severity of electromagnetic interference between the two machines. Our results suggest that the synchronization method used yields an accuracy of approximately 1 ms. Electromagnetic interference was derived from the complex-valued signal amplitudes. This dependent variable was analyzed as a function of the recording status – i.e. on/off – of the interfering machines transmitters. The intermachine distance was varied between 1 m and 8.5 m. Results suggest that a distance of approximately 6.5 m is appropriate to achieve data quality comparable to that of single speaker recordings.

ULTRAX2020: Ultrasound Technology for Optimising the Treatment of Speech Disorders : Clinicians' Resource Manual

Ultrasound Visual Biofeedback (U-VBF) uses medical ultrasound to image the tongue in real-time during speech. Clinicians can use this information to both assess speech disorders and as a biofeedback tool to guide children in producing correct speech. Ultrasound images of the tongue are thought to be relatively intuitive to interpret, however, there is no easy way of using the ultrasound to diagnose speech disorders, despite it having the potential to identify imperceptible errors which are diagnostically important. This manual describes how to use ultrasound for the assessment and treatment of speech sound disorders in children. It is designed to be used in combination with Articulate Instruments Ltd. Sonospeech software by clinical partners of the Ultrax2020 project. However, the basic principles and resources contained within this document will be of use to anyone interested in using ultrasound in the speech therapy clinic.

Covert contrast and covert errors in persistent velar fronting

ABSTRACT Acoustic and articulatory studies demonstrate covert contrast in perceptually neutralised phonemic contrasts in both typical children and children with speech disorders. These covert contrasts are thought to be relatively common and symptomatic of phonetic speech disorders. However, clinicians in the speech therapy clinic have had no easy way of identifying this covertness. This study uses ultrasound tongue imaging to compare tongue contours for /t/and /k/in seven children with persistent velar fronting. We present a method of overlaying tongue contours to identify covert contrast at the articulatory level. Results show that all seven children, contrary to expectations, produced both /t/and /k/with near-identical tongue shapes showing no evidence of covert contrast. However, further analysis of one of the participants showed highly variable tongue shapes for /t/and /k/, including retroflex productions of both. Although not phonologically conditioned, this covert error is evidence of speech disorder at the phonetic level.

The Edinburgh Speech Production Facility’s articulatory corpus of spontaneous dialogue.

The EPSRC‐funded Edinburgh Speech Production is built around two synchronized Carstens AG500 electromagnetic articulographs (EMAs) in order to capture articulatory/acoustic data from spontaneous dialogue. An initial articulatory corpus was designed with two aims. The first was to elicit a range of speech styles/registers from speakers, and therefore provide an alternative to fully scripted corpora. The second was to extend the corpus beyond monologue, by using tasks that promote natural discourse and interaction. A subsidiary driver was to use dialects from outwith North America: dialogues paired up a Scottish English and a Southern British English speaker. Tasks. Monologue: Story reading of “Comma Gets a Cure” [Honorof et al. (2000)], lexical sets [Wells (1982)], spontaneous story telling, diadochokinetic tasks. Dialogue: Map tasks [Anderson et al. (1991)], “Spot the Difference” picture tasks [Bradlow et al. (2007)], story‐recall. Shadowing of the spontaneous story telling by the second participant. Each...